ORIGINAL ARTICLE
ACR Appropriateness Criteria Evaluation of the Symptomatic Male Breast Martha B. Mainiero, MDa, Ana P. Lourenco, MDa, Lora D. Barke, DOb, Amy D. Argus, MDc, Lisa Bailey, MDd, Selin Carkaci, MDe, Carl D’Orsi, MD f, Edward D. Green, MD g, Susan O. Holley, MDh, Peter M. Jokich, MDi, Su-Ju Lee, MDc, Mary C. Mahoney, MDc, Linda Moy, MD j, Priscilla J. Slanetz, MD, MPHk, Sunita Trikha, MDl, Monica M. Yepes, MDm, Mary S. Newell, MD f Abstract Most male breast problems are benign, and men with typical symptoms of gynecomastia or pseudogynecomastia do not usually need imaging. When a differentiation between benign disease and breast cancer cannot be made on the basis of clinical findings or when the clinical findings are suspicious for breast cancer, imaging is indicated. Mammography is useful in both identifying cancer and obviating the need for biopsy in patients for whom a benign mammographic impression confirms the clinical impression. However, because of the relationship of breast cancer to increasing age, age-based protocols that do not include mammography have been developed. For men with an indeterminate palpable mass, begin with ultrasound if the patient is
ACR Appropriateness Criteria Evaluation of the Symptomatic Male Breast Martha B. Mainiero, MDa, Ana P. Lourenco, MDa, Lora D. Barke, DOb, Amy D. Argus, MDc, Lisa Bailey, MDd, Selin Carkaci, MDe, Carl D’Orsi, MD f, Edward D. Green, MD g, Susan O. Holley, MDh, Peter M. Jokich, MDi, Su-Ju Lee, MDc, Mary C. Mahoney, MDc, Linda Moy, MD j, Priscilla J. Slanetz, MD, MPHk, Sunita Trikha, MDl, Monica M. Yepes, MDm, Mary S. Newell, MD f Abstract Most male breast problems are benign, and men with typical symptoms of gynecomastia or pseudogynecomastia do not usually need imaging. When a differentiation between benign disease and breast cancer cannot be made on the basis of clinical findings or when the clinical findings are suspicious for breast cancer, imaging is indicated. Mammography is useful in both identifying cancer and obviating the need for biopsy in patients for whom a benign mammographic impression confirms the clinical impression. However, because of the relationship of breast cancer to increasing age, age-based protocols that do not include mammography have been developed. For men with an indeterminate palpable mass, begin with ultrasound if the patient is
